Trying to shave its operating deficit, BJC Medical Center is closing its labor and delivery services, leaving three doctors scrambling to make alternative arrangements for patients.

“December 9 is the absolute last day we will deliver a baby,” announced CEO Jim Yarborough.

The cutback includes closing Commerce Women’s Clinic, a hospital-owned OB practice run by Dr. David Sauls, whose contract with BJC expires Dec. 9. The move will also bring to an end the delivery of babies by doctors Bob Marshburn and Beth Sullivan.

Marshburn of Medical Center Family Practice understands the problem.

“It’s tough to keep an OB wing open with the nurses and high-tech equipment if you’re not delivering a volume of babies that justifies it,” he said.

Both Marshburn and Sauls also predicted that closing the OB service at BJC will lead to cases where women show up at the emergency room in labor.

“You can have the EMS divert, but you’re always going to have somebody who just drives up in labor,” Sauls said. “You’re bound by laws. You can try to transfer them, but if you can’t find a hospital to accept them, you have to deal with it here.”

Yarborough said closing the OB unit could trim the hospital’s deficit by $500,000 to $750,000, Yarborough explained.

“We can no longer sustain OB services based on reimbursements,” said Yarborough, who added that the hospital would have to deliver 300 babies a year - with an appropriate Medicaid mix - to break even. Last year it delivered 66.

The move eliminates 12 positions at the hospital, but Yarborough speculated that some of those employees will be absorbed into other positions where vacancies exist.

BJC was struggling financially before the current economic slump hit. It lost its general surgeon and has seen its percentage of indigent care and charity care cases rise as the economy worsened.

“We’re having to cut costs,” said the CEO. “We can only cut so much staff until we cut services. We’ve had to cut a service that is not self-supporting.”